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Acute Kidney InjuryPhase 2KOURAGENCT06374797

A Study of Auxora in Patients With AKI and Injurious Lung "Crosstalk"

A Phase 2 study testing Auxora in people with Acute Kidney Injury, run by CalciMedica, Inc. at 33 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Approximately 150 patients with acute kidney injury (AKI) associated with acute hypoxemic respiratory failure (AHRF) will be randomized at up to 40 sites. Patients will be randomly assigned to either Auxora or matching placebo. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Acute Kidney Injury
What is being tested?
Auxora
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
122 participants
Where
33 sitesUnited States
Study dates
1 Jul 2024to 6 Apr 2026
Phase
Phase 2
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • The patient is ≥ 18 years of age.
  • The patient has developed Stage 2 or Stage 3 AKI.
  • The patient has a documented partial pressure of oxygen [Pa02]/fraction of inspired oxygen [FiO2] (P/F) ≤ 300 in the prior 24 hours, either imputed from SpO2 or obtained from an arterial blood gas, that is not explained by cardiogenic pulmonary edema or volume overload
  • The patient is being treated with either high flow nasal cannula with minimum flow rate ≥ 30 liters/min, or non-invasive mechanical ventilation, or invasive mechanical ventilation at time of randomization.
  • A female patient of childbearing potential who is sexually active with a male partner is willing to practice acceptable methods of birth control for 30 days after the last dose of study drug.
  • A male patient who is sexually active with a female partner of childbearing potential is willing to practice acceptable methods of birth control for 30 days after the last dose of study drug. A male patient must not donate sperm for 30 days after the last dose of study drug.
  • The patient is willing and able to, or has a legally authorized representative (LAR) who is willing and able to, provide informed consent to participate and to cooperate with all aspects of the protocol.

Who cannot join

  • The patient has a do not intubate directive.
  • The patient has chronic lung disease that requires supplemental non-invasive oxygen as an outpatient or home mechanical ventilation. The use of non-invasive mechanical ventilation to treat obstructive sleep apnea is not an exclusion.
  • The patient has been hospitalized in the ICU for more than 10 days.
  • The patient has been receiving invasive mechanical ventilation for > 120 hours.
  • The patient is receiving extracorporeal membrane oxygen (ECMO).
  • The patient has started or is planned to start kidney replacement therapy (KRT) before randomization.
Show all 17Show fewer
  • The patient has a serum triglyceride level ≥ 500 mg/dL.
  • The patient has a direct bilirubin level >3.0 mg/dL or both a direct bilirubin level ≥ 2.0 mg/dL and an international normalized ratio (INR) ≥ 1.7.
  • AKI is suspected to be secondary to: renal artery or renal vein thrombosis; hepato-renal syndrome; cholesterol emboli syndrome; acute glomerulonephritis; vasculitis; acute allergic interstitial nephritis; intrarenal or extrarenal urinary tract obstruction; use of immune checkpoint inhibitor.
  • The patient has a known history of an organ transplant.
  • The patient has a known history of HIV infection.
  • The patient has known history of hepatitis B infection.
  • The patient is currently receiving chemotherapy.
  • The patient is currently receiving immunosuppressive medications
  • The patient is known to be pregnant or is currently nursing.
  • The patient is allergic to eggs.
  • The patient is currently participating in another study of an investigational drug

Trial locations and contacts

33 sites in 1 country.

33 sites in 1 country

United States33 sites
  • Cleveland Clinic Akron General

    Akron, Ohio, 44307

  • University of Colorado Hospital

    Aurora, Colorado, 80045

  • University of Alabama

    Birmingham, Alabama, 35249

  • St Luke's Hospital

    Boise, Idaho, 83712

  • Brigham & Woman's Hospital

    Boston, Massachusetts, 02115

  • NYU Langone Health - Brooklyn

    Brooklyn, New York, 11220

  • Lahey Hospital and Medical Center

    Burlington, Massachusetts, 01805

  • Chandler Regional Hospital

    Chandler, Arizona, 85224

  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • University of Virginia

    Charlottesville, Virginia, 22903

  • Northwestern University-Pulmonary & Critical Care Medicine

    Chicago, Illinois, 60611

  • Cleveland Clinic

    Cleveland, Ohio, 44095

  • University Hospitals Cleveland Medical Center

    Cleveland, Ohio, 44106

  • University of Missouri

    Columbia, Missouri, 65212

  • The Ohio State University

    Columbus, Ohio, 43202

  • Baylor Scott and White Research Institute

    Dallas, Texas, 75246

  • Geisinger Medical Center

    Danville, Pennsylvania, 17822

  • Henry Ford

    Detroit, Michigan, 48202

  • Hannibal Regional

    Hannibal, Missouri, 63401

  • UT Houston

    Houston, Texas, 77030

  • University of Indiana

    Indianapolis, Indiana, 46202

  • University of Iowa

    Iowa City, Iowa, 52243

  • Emory Johns Creek Hospital

    Johns Creek, Georgia, 30097

  • University of Arkansas for Medical Sciences

    Little Rock, Arkansas, 72205

  • UCLA

    Los Angeles, California, 90095

  • My Michigan Health

    Midland, Michigan, 48670

  • NYU Langone Health - Bellview

    New York, New York, 10016

  • NYU Langone Health - Tisch Hospital

    New York, New York, 10016

  • Temple University

    Philadelphia, Pennsylvania, 19140

  • Stanford Health Care

    Stanford, California, 94304

  • Tampa General

    Tampa, Florida, 33606

  • Holy Name

    Teaneck, New Jersey, 07666

  • Torrance Memorial Medical Center

    Torrance, California, 90502

Other trials in United States

About this study

Official title: Auxora for the Treatment of AKI and Modulation of Injurious "Crosstalk" With the Lung: A Randomized Control Trial (KOURAGE)

Approximately 150 patients with acute kidney injury (AKI) associated with acute hypoxemic respiratory failure (AHRF) will be randomized at up to 40 sites. Patients will be randomly assigned to either Auxora or matching placebo. Study drug infusions will occur every 24 hours for five consecutive days for a total of five infusions.

Read the detailed description

This double blind, randomized, placebo-controlled study will evaluate the efficacy, safety, and tolerability of Auxora in patients with severe AKI who have associated AHRF. The definition of AKI and the stages of AKI will be based on the classification system proposed by the Acute Kidney Injury Working Group of Kidney Disease: Improving Global Outcomes (KDIGO) and incorporate both serum creatinine and urine volume criteria. AHRF will be defined as a P/F ≤ 300 that has been determined by either an arterial blood gas or imputed from the oxygen saturation (SpO2) recorded using pulse oximetry and is being treated with high flow nasal cannula with minimum flow rate ≥ 30 liters/min, or non-invasive mechanical ventilation, or invasive mechanical ventilation. Approximately 150 patients with severe AKI, defined as having developed either stage 2 or 3 AKI at the time of consent, who have associated AHRF will be randomized 1:1 into either the Auxora or placebo group using a computer-generated randomization scheme accessed through an interactive voice/web response system (IXRS). Randomization will be stratified by the use of invasive mechanical ventilation and by Stage 3 AKI.

Patients who are randomized to the Auxora group will receive 1.25 mL/kg (2.0 mg/kg of zegocractin) IV over 4 hours at 0 hours and then 1.0 mL/kg (1.6 mg/kg of zegocractin) IV over 4 hours at 24, 48, 72, and 96 hours for a total of 5 doses. Patients who are randomized to the placebo group will receive 1.25 mL/kg IV over 4 hours at 0 hours and then 1.0 mL/kg IV over 4 hours at 24, 48, 72, and 96 hours for a total of 5 doses. Placebo will be a matching emulsion without the active pharmaceutical ingredient zegocractin. The sponsor, investigators, pharmacists, and patients will be blinded to the assigned group. The Start of First Infusion of Study Drug (SFISD) should occur no more than 24 hours of the patient or legally authorized representative (LAR) providing informed consent. A study physician or appropriately trained delegate will perform study-specific hospital assessments immediately prior to the SFISD, and then every 24 hours after the SFISD until 720 hours (Day 30), or until discharge if earlier. All patients, including those that are discharged from the hospital to home, or to a skilled nursing facility, or to an extended care facility, will be assessed at Day 90.

All AKI should be managed according to the KDIGO 2012 guidelines which recommends maintaining adequate organ perfusion, avoiding volume overload, avoiding hyperglycemia, discontinuing nephrotoxic agents, and adjusting dosing of renally excreted medications. AHRF/acute respiratory distress syndrome (ARDS) should be managed according to the 2023 European Society of Intensive Care Medicine (ESICM) major recommendations.

Being tested
Auxora, Placebo
Keywords
AKI, Acute Kidney Injury, Auxora
Medical subject headings
Acute Kidney Injury

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • AuxoraDrug

    1.25 mL/kg (2.0 mg/kg of zegocractin) intravenously (IV) over 4 hours at 0 hours, and then 1.0 mL/kg (1.6 mg/kg of zegocractin) IV over 4 hours at 24, 48, 72 and 96 hours for a total of 5 doses.

  • PlaceboDrug

    1.25 mL/kg IV over 4 hours at 0 hours and then 1.0 mL/kg IV over 4 hours at 24, 48, 72, and 96 hours for a total of 5 doses.

Study groups in NCT06374797
Study groupRoleWhat they receive
AuxoraExperimentalNot described
Receives: Drug: Auxora
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Days alive, ventilator-free and kidney replacement therapy (KRT)-free from SFISD through Day 30

    The primary efficacy analysis will apply the win ratio method and the Finkelstein-Schoenfeld method to the primary endpoints. The win ratio method allocates all Auxora and placebo pairs to the components that comprise the primary endpoint in a hierarchical fashion.

    Categories (a) and (c) represent Auxora wins based on all-cause mortality and days ventilator-free and KRT-free. Similarly, categories (b) and (d) represent placebo wins. Category (e) represents ties.

    (a) Death on placebo, but alive on Auxora at day 30 (b) Death on Auxora, but alive on placebo at day 30 (e) Death on placebo and death on Auxora at day 30

    If alive on placebo and alive on Auxora at day 30:

    (c) Greater number of days alive, ventilator-free and KRT-free on Auxora (d) Greater number of days alive, ventilator-free and KRT-free on Placebo (e) Equal number of days alive, ventilator-free and KRT-free We will calculate the overall win ratio by adding (a) + (c) and dividing it by the sum of (b) + (d).

    Measured: SFISD through Day 30

Secondary outcomes (11)
  1. Major adverse kidney event (MAKE) 90-1: ≥25% decline in estimated glomerular filtration rate (eGFR) from baseline, incident KRT, and all-cause mortality at 90 days

    Measured: At Day 90

  2. MAKE 90-2: ≥35% decline in eGFR from baseline, incident KRT, and all-cause mortality at 90 days

    Measured: At Day 90

  3. Proportion of patients alive at Day 30

    Measured: At Day 30

  4. Proportion of patients alive at Day 90

    Measured: Day 90

  5. Days alive and ventilator-free from start of first infusion of study drug (SFISD) through Day 30

    Measured: SFISD through Day 30

  6. Days alive and KRT-free from SFISD through Day 30

    Measured: SFISD through Day 30

  7. Proportion of patients recovered from AHRF through Day 30 as categorized by an 8-point ordinal scale

    The measurement tool is an 8-point ordinal scale: 1=Death; 2=Hospitalized, requiring invasive mechanical ventilation or extracorporeal membrane oxygenation(ECMO); 3=Hospitalized, requiring non-invasive ventilation or high flow supplemental oxygen; 4=Hospitalized, requiring low flow supplemental oxygen; 5=Hospitalized, not requiring supplemental oxygen but requiring ongoing medical care; 6=Hospitalized, not requiring supplemental oxygen or ongoing medical care; 7=Discharged, requiring supplemental oxygen; 8=Discharged, not requiring supplemental oxygen

    Measured: SFISD through Day 30

  8. Proportion of patients receiving KRT at Day 30

    Measured: At Day 30

  9. Proportion of patients receiving KRT at Day 90

    Measured: At Day 90

  10. Number of patients with treatment-related adverse events (TEAE)

    Measured: SFISD through Day 90

  11. Number of patients with grade 3 TEAEs

    Measured: SFISD through Day 90

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Apr 2024
  2. Study start1 Jul 2024
  3. Primary completion6 Apr 2026
  4. Study completion6 Apr 2026

Why it stopped: The study was stopped due to imbalance in randomization stratification of severe patients.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
122 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06374797
Sponsor's protocol ID
CMZ-207
Acronym
KOURAGE
Status last verified
Aug 2026
First submitted
16 Apr 2024
Last updated
31 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Auxora in people with Acute Kidney Injury, run by CalciMedica, Inc. at 33 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 31 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 33 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: The study was stopped due to imbalance in randomization stratification of severe patients.). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Days alive, ventilator-free and kidney replacement therapy (KRT)-free from SFISD through Day 30 (time frame: SFISD through Day 30). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Aug 2026.

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